<style type="text/css">
	.layui-form-mid {
	    float: left;
	    display: block;
	    padding: 0 !important;
	    line-height: 40px;
	    margin-right: 10px;
	    width: 250px;
	}
</style>
<form class="layui-form info-form" action="">
	<input name="id" id="id" type="hidden" value="{$info.id}">
	<input name="order_id" id="order_id" type="hidden" value="{$info.order_id}">
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">订单编号：</label>
			<div class="layui-form-mid">
				{$info.order_num}
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">收货人：</label>
			<div class="layui-input-inline">
				<input name="receiver_name" id="receiver_name" value="{$info.receiver_name}" lay-verify="required" autocomplete="off" placeholder="请输入收货人" class="layui-input" type="text">
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">收货手机：</label>
			<div class="layui-input-inline">
				<input name="receiver_mobile" id="receiver_mobile" value="{$info.receiver_mobile}" lay-verify="required" placeholder="请输入收货人手机" autocomplete="off" class="layui-input" type="text">
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<label class="layui-form-label">收货城市：</label>
		{:W('city/select',array($info['district_id'],3))}
	</div>
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">详细地址：</label>
			<div class="layui-input-inline">
				<input name="address" id="address" value="{$info.address}" lay-verify="required" placeholder="请输入收货详细地址" autocomplete="off" class="layui-input" type="text">
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">运费/元：</label>
			<div class="layui-input-inline">
				<input name="freight_amount" id="freight_amount" value="{$info.freight_amount}" lay-verify="required" placeholder="请输入物流运费" autocomplete="off" class="layui-input" type="text" disabled>
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-inline">
			<label class="layui-form-label">物流公司：</label>
			<div class="layui-input-inline">
				{:W('common/singleSelect',array('express_id|1|物流公司|e_name|id',M("expresses")->where(['mark'=>1])->select(),$info['express_id']))}
			</div>
		</div>
		<div class="layui-inline">
			<label class="layui-form-label">物流单号：</label>
			<div class="layui-input-inline">
				<input name="express_no" id="express_no" value="{$info.express_no}" lay-verify="required" placeholder="请输入物流单号" autocomplete="off" class="layui-input" type="text">
			</div>
		</div>
	</div>
	<div class="layui-form-item">
		<label class="layui-form-label">用户备注：</label>
		<div class="layui-input-block" style="display: block;padding: 5px auto;font-weight: 400;line-height: 25px;">
			{$info.leave_message}
		</div>
	</div>
	<div class="layui-form-item">
		<label class="layui-form-label">确认备注：</label>
		<div class="layui-input-block" style="display: block;padding: 5px auto;font-weight: 400;line-height: 25px;">
			{$info.remark}
		</div>
	</div>
	<div class="layui-form-item layui-form-text" style="width:625px;">
		<label class="layui-form-label">发货备注：</label>
		<div class="layui-input-block">
			<textarea name="note" id="note" placeholder="请输入发货备注" class="layui-textarea">{$info.note}</textarea>
		</div>
	</div>
	<div class="layui-form-item">
		<div class="layui-input-block">
			<button class="layui-btn" lay-submit="" lay-filter="submitForm" id="submitForm">立即提交</button>
			<button type="reset" class="layui-btn layui-btn-primary">重置</button>
		</div>
	</div>
</form>